Application of Spinal Navigation in Anterior Cervical OPLL Surgery

Among the surgical treatments of ossification of the spinal ligaments, anterior surgery for ossification of the posterior longitudinal ligament (OPLL) is especially difficult, and various complications have been reported. Nowadays, intraoperative imaging modalities, such as fluoroscopic 3-dimensional images, mobile helical computed tomography (CT), and cone-beam CT, etc., are available in many institutions. The mobile intraoperative CT, which is an operation support tool, enables 3-dimensional imaging in a surgical position and also enables real-time navigation by linking with a navigation system. We introduce the procedure of anterior decompression and fusion for cervical OPLL with the support of the intraoperative CT-based navigation system. Furthermore, this system can be integrated with microscope to enable augmented reality (AR) surgery, which allows OPLL lesions to be visualized in the microscopic field of view. These systems are helpful methods to improve the accuracy and safety of anterior surgical procedures for cervical OPLL.